Tom Cotton says he wouldn't back changes for those on Medicare, but the ACA repeal he supports would

During a debate in the hotly contested Arkansas Senate race, Republican Tom Cotton and Democratic incumbent Mark Pryor squared off over the question of Medicare and how it would be affected by the Affordable Care Act, the health care law sometimes called Obamacare.

A moderator kicked off the exchange by noting that TV ads in the race had made several claims about possible changes to Medicare and where the candidates stood on those changes. Pryor was asked, "What specifically would you change about the current system, if anything?"

Pryor answered by parrying a charge that he had voted to cut $700 billion from Medicare by voting for Obamacare. (We have rated Cotton’s earlier claim that Pryor "cut Medicare to pay for Obamacare" by $700 billion Half True.) In fact, Pryor said that Cotton "has voted for that very same $700 billion (cut) he loves to criticize me for." (We rated a close variation of that claim True.)

When given an opportunity to respond, Cotton took the questioner’s claim head-on. Cotton said, "The answer to your question is: I will make no changes to the current (Medicare) system for current retirees and anyone approaching retirement."

We wondered if that was what his platform really shows.

The answer hinges on two separate questions. First, Does Cotton support repeal of Obamacare? And second, if Obamacare is repealed, would that prompt changes to Medicare either for current retirees or people approaching retirement?

The short answers are yes and yes. Here are the more detailed explanations.

Does Cotton support the repeal of Obamacare?

Cotton’s staff didn’t return an inquiry from PolitiFact, but we found lots of examples of Cotton arguing that Obamacare should be repealed.

• "I will fight to repeal and replace Obamacare with free-market reforms that empower patients and doctors to make health-care decisions. … Obamacare must be repealed entirely." -- Cotton’s House of Representatives office website, accessed Oct. 15, 2014.

• I "will fight to repeal Obamacare." -- Cotton’s Facebook page, accessed Oct. 15, 2014.

• "What we have to do is repeal Obamacare, start over, and get it right." -- Cotton at a press conference with former Republican presidential nominee Mitt Romney, Aug 21, 2014.

• "We would repeal Obamacare and replace it entirely with many reforms for our health care program." -- Cotton at a press conference, April 13, 2014

• And most clearly, a pledge Cotton signed that says, "I pledge to vote for all bills which seek to REPEAL the health care bill, HR 3590, signed into law on March 23, 2010. To that end, I do now and will in the next Congress endorse and vote for all measures, including discharge petitions, leading to its defunding, deauthorization, and repeal. I shall do so whether those measures are taken for the whole of the bill or those component parts that impose mandates, restrict patient and doctor choice and access, violate individual freedom and privacy, reduce healthy competition, increase costs, or raise taxes."

It’s worth noting that, at times, Cotton has expressed a desire to "replace" the newly repealed law with something else. However, we’ve failed to uncover an instance in which Cotton provided a detailed description of the Medicare policies that would be reinstated after a repeal.

Cotton has also expressed an openness to more limited efforts, such as defunding the law, if a repeal can’t be achieved. Still, it’s clear from these comments that repeal is his first choice.

Bottom line: Yes, Cotton has said consistently that he wants to repeal the law.

If Obamacare is repealed, would that prompt changes to Medicare for current beneficiaries?

It would. The highest-profile element of the law that would disappear in the event of a full repeal is the closing of the "doughnut hole." The law made strides to ease the previous, longstanding gap in coverage for beneficiaries in which they weren’t able to get government subsidies for prescription drug purchases under Medicare Part D.

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However, this isn’t the only example of a benefit included in the Affordable Care Act that would disappear for those currently on Medicare if the law is repealed and replacement provisions aren’t specifically enacted. Here are others, gleaned from the Kaiser Family Foundation’s summary of the health care law:

• Elimination of cost-sharing for Medicare-covered preventive services.

• Authorization of Medicare coverage of "personalized prevention plan services," including an annual, comprehensive health-risk assessment.

• Incentives to Medicare and Medicaid beneficiaries to complete behavior-modification programs, such as smoking cessation.

• Reduction in the out-of-pocket amount that qualifies an enrollee for catastrophic coverage for prescriptions.

• Expansion of Medicare coverage to individuals who have been exposed to environmental health hazards from living in an area subject to an emergency declaration made as of June 17, 2009, and have developed certain health conditions as a result.

• Prohibition of Medicare Advantage plans from imposing higher cost-sharing requirements for some Medicare-covered benefits than is required under the traditional fee-for-service program.

In other words, current Medicare beneficiaries would feel a significant impact if a replacement law is not forthcoming after a repeal. We see no evidence that Cotton has pledged to protect any of these specific provisions in the wake of a repeal.

Our ruling

Cotton said that under his platform, he "will make no changes to the current (Medicare) system for current retirees and anyone approaching retirement."

Cotton has consistently supported repeal of Obamacare, and while he has sometimes noted that something needs to be enacted to "replace" the law, we couldn’t find any examples in which he specifically pledged to protect the Medicare policies that would be eliminated if the law was repealed, such as the closing of the doughnut hole and free preventive health-care services. We rate his claim False.